Healthcare Provider Details

I. General information

NPI: 1265550636
Provider Name (Legal Business Name): NINA ANN TINSLEY M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 W DIVISION ST
SPRINGFIELD MO
65802-1087
US

IV. Provider business mailing address

9090 W VETERANS BLVD
CLEVER MO
65631-6869
US

V. Phone/Fax

Practice location:
  • Phone: 417-862-6308
  • Fax:
Mailing address:
  • Phone: 417-860-2006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2002017405
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: